Lecture # 105:
Autism, Continued

copyright 2008 Cheryl K. Hosken, BSN, MS Psych.

Objectives for this lecture:

  1. The student will understand why social stories help autistic children.
  2. The student will know how sensory integration helps the autistic child learn to coordinate his senses.
  3. The student will be familiar with usual medical therapies.

Social Stories
Social Stories were developed in 1991 by Carol Gray as a tool for teaching social skills to children with autism. They address the inability to understand or recognize feelings, points of view, or plans of others. Through a story developed about a particular situation or event, the child is provided with as much information as possible to help him or her understand the expected or appropriate response.

Meditate Word By Word On These Verses:
Matt. 12:43-45.

The stories typically have three sentence types:

Question:
1. When writing a social story, the writer's objective is:
(Select the best answer.)
a) to teach the child a lesson.
b) to help him understand himself.
c) help him understand the cause of his feelings.

 

 

The stories can be written by anyone, are specific to the child's needs, and are written in the first person, present tense. They frequently incorporate the use of pictures, photographs or music.

Before developing and using social stories, it is important to identify how the child interacts socially and to determine what situations are difficult and under what circumstances. Situations that are frightening, produce tantrums or crying, or make a child withdraw or want to escape are all appropriate for social stories. However, it is important to address the child's misunderstanding of the situation. A child who cries when his/her teacher leaves the room may be doing so because he/she is frightened or frustrated. A story about crying won't address the reason for the behavior. Rather a story about what scares the child and how he can deal with those feelings will be more effective.

Question:
2. Social stories:
(Select the best answer.)
a) help a child understand his life.
b) help a child understand reasons for feelings.
c) provide a child with information.

 

 

What is "Personal Space?"
I have an area around my body that is called my "personal space." This space is like an invisible bubble. Sometimes my personal space is large. When it is large, my personal space goes out to my fingertips. When my personal space is large, I want other people to stay outside of it. When my personal space is large, I do not touch other people, and I don't want them to not touch me. This helps all of us to feel comfortable.

Sometimes my personal space is small. When my personal space is small, it is about the same size as my body. When my personal space is small, I might touch other people, and they might touch me. Here is an example of the concept of "personal space" or how to know the distance one keeps from another person's body:

Some children may struggle with the concept of personal space because of problems with sensory integration. This occurs when the senses are not working together to process sensory signals from the child's environment (including touch, sight, smells, and sounds). The child's brain does not integrate all of the information to properly decode and respond to it. A light tap or brush against the child's arm may be perceived as a hard hit, and the child may respond accordingly.

A lack of awareness of where his or her own body begins and ends (a common problem for those with sensory integration dysfunction) can cause a child to bump into others or to step on their toes, and similar difficulties may lead the child to use excessive force when the intent was only to give a friendly pat on someone's arm. An occupational therapist can help to determine whether this is an issue for a particular child, and through a sensory diet and sensory integration therapy, can help the child to better process -- and respond to -- sensory input.

The child with ASD is only one half of the "personal space equation." Parents, teachers, and caregivers can help to protect the personal space of the child with ASD. It is helpful to monitor that classmates do not sit so close to the child that unnecessary "bumps" are going to occur. The child can be allowed to stand at the back of the line, where the only personal space she needs to be concerned about lies directly in front of her (or if the child cannot handle being in the back, he or she can be placed alongside a line of children).

Parents and professionals can also model their own corrections of personal space "errors" by verbalizing, "Oops! I'm getting a little too close to all of you"…and then, after moving away slightly, "There, this is more comfortable for me, and you, too, I'll bet!" As with most concepts, it is important to approach "Personal Space" through a variety of ways, helping the child with ASD to understand a complicated social phenomenon that many people take for granted.

Who has "Personal Space?"
Every person has personal space. I have personal space. My mom has personal space. My dad has personal space. My teacher has personal space.

Why is Personal Space sometimes large, and sometimes small?
Sometimes I can choose how large my personal space will be. If I am with a person I don't know very well, I might choose to have a large personal space. This leaves a comfortable distance between the other person and me. If I feel like being alone, I might choose to have a large personal space. If there are a lot of noises or activities around me, I might choose to have a large personal space. When I have a large personal space, I can talk to other people or sit near them, but I will not touch them, and they will not touch me.

Sometimes I can choose how small my personal space will be. If I am with a person who I know well, or who is special to me, I might choose to have a small personal space. When I know a person well, a small personal space is a comfortable distance. When I have a small personal space, I can sit near other people and have part of my body touching part of their body.

Sometimes I cannot choose how large my personal space will be. Sometimes I cannot choose how small my personal space will be. When I have to sit on a chair that is very close to another person's chair, I will probably have a small personal space. When I walk through a crowded hallway or on a busy sidewalk, I will probably have a small personal space.

When I cannot choose the size of my personal space, I might have people touch me when I do not want them to touch me. People might also touch me when I am not expecting them to touch me.

When I cannot choose a large personal space, I will try to stay calm. I can tell someone, "I need more personal space." If they can help me, they might give me more personal space. If they cannot help me, I can wait awhile. Usually, after waiting awhile I will be able to choose a larger personal space.

In conclusion, we note there are many types of therapy useful for the autistic child. The emphasis for each therapy is to begin when the child is young, try to understand what the child is learning, and do not give up on him.

Sensory Integration
Children with autism frequently have sensory difficulties. They may be hypo- or hyper-reactive or lack the ability to integrate the senses. Sensory integration therapy, usually done by occupational, physical or speech therapists, focuses on desensitizing the child and helping him or her reorganize sensory information. For example, if a child has difficulties with the sense of touch, therapy might include handling a variety of materials with different textures.

The following information about sensory integration was written by Laurel A. Hoekman, an occupational therapist:

Our bodies are intended to function as "well-oiled machines," which receive input from the senses, and organize and process that information to be able to use it appropriately, or to act on it. Our senses include hearing, seeing, touching, tasting, and feeling, as well as the processes of movement and gravity. When these systems are all working properly, and the brain is able to correctly interpret the information they send, we refer to this process as sensory integration; the senses are working together!

However, when there are imperfections in this system, we call that "sensory integration dysfunction." Although there are many variations in the ways that sensory integration dysfunction (or sensory processing difficulties) can present itself, there are two main underlying problems.

  1. The first is when a person receives too much sensory input; in effect, their brain is overloaded.
  2. The second is when a person does not receive enough sensory input, resulting in a "craving" of sensory information.

The following section will discuss how each of the senses affects behaviors, as well as potential problems, which arise when sensory integration dysfunction is present.

Hearing. We use our ears to hear voices, music, alarms and sirens, as well as noise around us generated by electronic equipment, nature, etc. When our brains are able to properly receive and organize the data they receive through our ears, we are able to sense danger, process information and instructions, and feel pleasure through music or sounds of nature. A person whose senses are well integrated can sit in the middle of a noisy party with music, talking, glasses and silverware clinking, and still be able to carry on a conversation with the person sitting across the table. This person's brain simply filters out the unnecessary information, and focuses on the words the individual speaker is saying.

In contrast, a person with sensory integration dysfunction may hear all of the above sounds at the same level, in effect being bombarded by each of the sounds. This person will be unlikely to follow the conversation directed at them by the person across the table. Imagine a similar child in a classroom, surrounded by pencils being sharpened, children talking, music playing, feet shuffling, and chairs being scraped across the tile floor. This child may not be able to complete the math or reading assignments correctly with all of the other stimuli overloading his brain. This child may exhibit behavioral problems resulting from his frustration and inability to screen out unnecessary sensory input. The teacher may notice that the child is "clowning around," staring into space, or flapping his hands. This child may become terrified of the fire alarm, because that sound is painful.

Another child may struggle when the room is quiet, because that child is not receiving enough input through his hearing. This child may begin tapping his pencil, humming, kicking his desk, or otherwise producing his own noise. All children are different in their needs, but the teacher should be sensitive to the child with sensory integration dysfunction, taking time to determine whether that child needs a quiet area to study, a set of headphones to block out extra sounds, or perhaps a stereo headset to provide quiet music.

Seeing. Our eyes show us such things about color, light, movement, locations, body language, and facial expressions. This information, when properly received and analyzed by our brains, allows us to find our way around, read, interpret body language and facial expressions, anticipate movement, and sense danger.

A child who is under-reactive to sight stimuli might flick her fingers in front of her face, or hold a book close to her eyes. On the other hand, a child who is overly sensitive or overly reactive to visual input might be frightened in a crowded mall, or become either withdrawn or hyperactive in a room with bright lights and an abundance of color or movement. People with sensory integration dysfunction may not respond appropriately to others' facial expressions, due to their inability to properly organize visual input. A large classroom which is visually stimulating, with colored posters, stacks of books, bright lights and windows, rows of desks, and many children, can be very distracting to the person with sensory integration disorder, and may require that special accommodations be made for that person.

Smelling. We are often surrounded by fragrant scents from perfume and flowers, and smells and freshly baked bread or cookies. Other smells we encounter in our environment include cleaning agents, newly mowed grass, car exhaust, and smoke. Our sense of smell can bring us pleasure, enhance our ability to taste our food, and warn us of danger. However, as with the other senses, the sense of smell can cause frustration for a person whose brain is not able to properly analyze, filter out, or respond to the information it receives.

Some people are overly sensitive to smells, and a whiff of perfume or cleansers can be very distressing to them. Other people are under-reactive to smells, and may hold things close to their nose to be able to smell them better. Whether they are overly- or under-reactive to smells, students who are keenly aware of the smells around them in the classroom or home may be unable to concentrate on the tasks they should be doing.

Question:
3. The child with lack of sensory integration may have a problem with:
(Only one of the following answers is correct.)
a) not feeling things appropriately.
b) under-stimulation or over-stimulation.
c) analyzing smell.

 

 

Taste. Taste often brings us pleasure. We tend to eat the things that taste good! But taste can also warn us of danger. We know that milk may be sour or food may be spoiled based on the way they taste. But a person with sensory integration dysfunction may be either a very picky eater, avoiding certain (or many) tastes and textures, or may be an indiscriminate eater, eating almost anything! Taste is an area that will likely cause more distress and grief for the parents of children with sensory problems, than for teachers and peers.

Touch. We only have two eyes, two ears, and one nose, but our bodies are covered with very sensitive touch receptors. Through them we get information about hot and cold, hard and soft, smooth and rough, and pain and pleasure. When a person's brain is receiving and analyzing this information from the tactile system correctly, he will quickly remove his hand from a hot stove, put mittens on when going out into the snow, and smile when receiving a caress from a loved one.

However, a person who has sensory integration dysfunction may react violently to a warm surface or a gentle pat on the back. He may not remember to wear mittens even on an extremely cold day, or he may always wear long sleeves, even when it's warm, because he dislikes having his skin exposed. If he is under-reactive to touch, he may receive a serious wound, acting as though it is merely a scratch. He may hate to get his hands dirty and to touch unfamiliar objects, or may have an intense need to touch anything and everything.

This child may have difficulty standing in line, because either he will be touching everyone, or he will be complaining that everyone is touching him. Often he may perceive a light touch from a classmate as a hit, and he may strike out at the other child. Parents may have difficulty choosing a wardrobe for this child, because there are certain fabrics or articles of clothing that he refuses to wear, or the tags in the back are bothersome to him.

A child with tactile defensiveness or a need to touch things, may benefit from carrying a stimulating object in his pocket. This may be a small textured ball, a key ring, or something that vibrates. When the child needs help concentrating, or needs to be able to touch something, he can reach into his pocket for that item. Many children with sensory integration dysfunction twirl their hair, rub their fingers together, or even chew their fingernails.

Vestibular System. Although most people are familiar with the above senses, there are actually two other systems that play a very large role in our brains' ability to receive information and to respond to it. The first is the vestibular system, which has to do with movement and balance. A person with sensory integration dysfunction may be hyper-responsive (over-reactive) to movement, or hypo-responsive (under-reactive) to movement.

Hyper-responsiveness to movement may cause a person to experience motion sickness in the car or on an amusement park ride. This person may be afraid of heights or dislike being upside down, which is referred to as gravitational insecurity. This person may seem stiff, and even hold his head upright, to avoid excessive movement. Problems with their vestibular system may have caused the strange crawl that some children develop; they do not like to put their heads down, and crawled in a way that allowed them to keep their heads upright. A child with these difficulties may struggle on the playground or in physical education classes, where they may be expected to swing, go on a merry-go-round, hang upside down, or run.

Hypo-responsiveness to movement may result in a child who is always moving: spinning, swinging, rocking, flapping his hands and fidgeting. Many children with sensory integration dysfunction appear as though they have Attention Deficit with Hyperactivity Disorder (ADHD) simply because they rarely stop moving. These children often exhibit poor balance, and may have difficulty walking around objects, bumping into walls and tripping over chairs. They might enjoy hanging upside down, and appear able to spin without becoming dizzy. While a child with sensitivity to movement has many frustrations outdoors, hyperactive children have problems indoors, especially during times when they are expected to be quiet and attentive.

Match these terms with the definitions below:
A. Touch. - B. Taste. - C. Vestibular.

4-1. Balancing on a swing.
A, B, C,

4-2. Has difficulty eating any food.
A, B, C,

4-3. Wants his body covered at all times.
A, B, C,

 

 

Proprioceptive System. The last system deals with body position, and is known as the proprioceptive system. This system is often referred to as "awareness of body in space." When this system functions properly, it allows us to sit down onto a chair without falling, walk up and down stairs without watching our feet, close a door with just the right amount of effort, squeeze a glue bottle just hard enough to squirt out a small dot of glue, and walk down a crowded sidewalk without bumping into anyone.

Disturbances in this system can obviously lead to problems. A person who does not know how far her arm extends may end up hitting someone as she reaches for an object. This person may step on someone's foot as she walks, not realizing that a foot was in her way. He may slam doors, or close them so lightly that they do not latch. He may be clumsy, and may be unable to climb a piece of playground equipment or walk up stairs without difficulty, perhaps needing to watch his feet to see where to place them. Problems with the proprioceptive system can be the main problem for difficulties with motor planning, which is the ability to figure out how to use one's body. For example, when walking under a low doorway, most people know just how far to bend down to avoid hitting their head. A person with motor planning difficulties may bend over too far, or not far enough. Routine tasks such as dressing, tying shoes, eating with utensils, and writing can be challenges for people with motor planning difficulties.

Match these terms with the definitions below:
A. Smelling. - B. Seeing. - C. Hearing. - D. Proprioception.

5-1. Covers his ears in a classroom.
A, B, C, D.

5-2. Becomes sick when his mother wears perfume.
A, B, C, D.

5-3. Watches his feet when he climbs the stairs.
A, B, C, D.

5-4. Becomes frightened when he sees bright colors and sunlight in a room.
A, B, C, D.

 

 

Remember that not all individual preferences or behavioral problems are caused by sensory integration dysfunction. Some people prefer to work with the radio on. Some people like "dirty work" more than others. Generally, a person who has sensory processing difficulties will manifest this in several different areas. However, if you recognize your child in the preceding descriptions, do not despair! Many things can be done to enable a person's brain to properly receive and respond to sensory stimuli.

First, provide the child with an environment that is full of a variety of sensory input: light and dark colors, sounds, music, things to climb on, different textures, and opportunities for movement and exploration, exposing all of the senses to various types of input. This varied exposure to sensory input (targeting specific needs) is often referred to as a sensory diet.

It is important to learn what excites a child, what calms him, and what frightens him. Allow the child to choose activities that fit his needs and interests. Providing different experiences, along with support and encouragement, will be a good foundation for helping your child with sensory problems.

Second, knowing that a child may encounter things that are disturbing or overwhelming, help her to adapt the activity, or even avoid it when necessary. If a child does not like light touch (many people with sensory integration dysfunction do not), make a point of using a firm, calming, deep pressure touch. If your child cannot study in an environment with a high level of noise and other stimuli, help him to find a quiet place to complete assignments and prepare for tests.

Remember that a child may not be able to process a lot of sensory input simultaneously. For example, she may not be able to talk while she is walking on a balance beam. She may not be able to look at you when you are giving her verbal instructions. Although you might encourage a child to make eye contact with people when greeting them, asking a question, or beginning or ending an interaction, he or she might not be able to look at you when you are giving instructions or discipline. Instead, when we have finished, we ask the child to rephrase what was said in order to monitor his or her comprehension.

Many children benefit from Sensory Integration (SI) Therapy, through their schools (if their ability to learn is disrupted). Usually, SI therapy focuses on the tactile, vestibular, and proprioceptive systems. This therapy does not teach specific skills; rather, it provides exposure to sensory input in a controlled environment. Once children are able to tolerate and subsequently process the sensory input, they are able to catch up on skills that they may have been missing. Sensory Integration Therapy can be a wonderful way for parents to learn activities to do with their children at home! Once you learn about SI from occupational therapists, you can begin incorporating many different activities into your daily routine, including trips to the playground, "messy" play with paint, modeling clay, and sand, and a variety of exercises. Trained therapists can also provide an evaluation of a child to better determine what that child's needs are.

Some children need deep pressure in order to calm themselves and to help their brains organize and process sensory input. Children who crave deep pressure may benefit from using a weighted vest, blanket, or wrist or ankle weights. There are many deep pressure activities you can do with children.

The Wilbarger Brushing Method, developed by Patricia and Julia Wilbarger, uses a surgical scrub brush to stimulate the touch receptors, followed by deep pressure (proprioception) on the joints. A trained therapist could determine whether a child might benefit from brushing, and could instruct parents on how to use this method with their child.

Although adults are generally able to control their environment by making decisions about the sights, smells, and sounds that surround them, as well as the activities that they engage in, children rarely have the "luxury" of avoiding uncomfortable sensory stimuli in this way. In a crowded, activity-filled classroom, there is often no opportunity to escape the noise and confusion. Activities such as finger painting, sculpting with clay, or dissecting a frog are planned for the entire class to participate in, and frequently, the student's performance is rated based on the successful completion of these tasks. It is important to talk with your child and his teacher to determine what activities and situations may be presenting challenges in the classroom and in other environments, and to help to provide a solution. There is much that can be done to help a child with sensory integration dysfunction!

Question:
6. Sensory Integration therapy is a normal part of what we teach children as they grow.
true / false.

 

 

Treatment with Drugs, Vitamins, or Diet
While there are no drugs, vitamins or special diets that can correct the underlying neurological problems that seem to cause autism, parents and professionals have found that some drugs used for other disorders are sometimes effective in treating some aspects of or behaviors associated with autism.

Changes to diet and the addition of certain vitamins or minerals may also help with behavioral issues. Over the past 10 years, there have been claims that adding essential vitamins such as B6 and B12 and removing gluten and casein from a child's diet may improve digestion, allergies and sociability. Not all researchers and experts agree about whether these therapies are effective or scientifically valid.

Medications
There are a number of medications, developed for other conditions, that have been found effective in treating some of the symptoms and behaviors frequently found in individuals with autism, such as hyperactivity, impulsivity, attention difficulties, and anxiety. The goal of medications is to reduce these behaviors to allow the individual with autism to take advantage of educational and behavioral treatments.

When medication is being discussed or prescribed, ask about the safety of its use in children with autism:

Given the complexity of medications, drug interactions, and the unpredictability of how each patient may react to a particular drug, parents should seek out and work with a medical doctor with an expertise in the area of medication management.

What medications are available?
There are a number of medications that are frequently used for individuals with autism to address certain behaviors or symptoms. Some have studies to support their use, while others do not. The information provided here is meant as an overview of the types of medications sometimes prescribed. Be sure to consult a medical professional for more information.

Serotonin re-uptake inhibitors have been effective in treating depression, obsessive-compulsive behaviors, and anxiety that are sometimes present in autism. Because researchers have consistently found elevated levels of serotonin in the bloodstream of one-third of individuals with autism, these drugs could potentially reverse some of the symptoms of serotonin dysregulation in autism.

Three drugs that have been studied are clomipramine (Anafranil), fluvoxamine (Luvox) and fluoxetine (Prozac). Studies have shown that they may reduce the frequency and intensity of repetitive behaviors, and may decrease irritability, tantrums and aggressive behavior. Some children have shown improvements in eye contact with people and responsiveness to them.

Anti-psychotic medications have been the most widely studied of the psychopharmacologic agents in autism over the past 35 years. Originally developed for treating schizophrenia, these drugs have been found to decrease hyperactivity, stereotypic behaviors, withdrawal and aggression in individuals with autism. Four that have been approved for use are clozapine (Clozaril), risperidone (Risperdal), olanzapine (Zyprexa) and quetiapine (Seroquel). Only risperidone has been investigated in a controlled study of adults with autism. Like the antidepressants, these drugs all have potential side effects, including sedation.

Question:
7. What two classifications of drugs help some symptoms of autism?

 

 

Vitamins and Minerals
Over the past 10 years or more, claims have been made that vitamin and mineral supplements may improve the symptoms of autism, in a natural way. While not all researchers agree about whether these therapies are scientifically proven, many parents and an increasing number of physicians report improvement in people with autism with the use of individual or combined nutritional supplements.

Perhaps the most common vitamin supplement used in autism is vitamin B, which plays an important role in creating enzymes needed by the brain. In 18 studies on the use of vitamin B and magnesium (which is needed to make vitamin B effective), almost half of the individuals with autism showed improvement. The benefits include decreased behavioral problems, improved eye contact, better attention, and improvements in learning.

Other research studies have shown that other supplements may help symptoms as well. Cod liver oil supplements (rich in vitamins A and D) have resulted in improved eye contact and behavior of children with autism. Vitamin C helps in brain function and symptoms that include depression and confusion. Increasing vitamin C has been shown in a clinical trial to decrease severity of symptoms in children with autism.

Using Vitamins and Minerals
If vitamins or minerals are going to be added the child's diet, a laboratory and clinical assessment of nutritional status is highly recommended. The most accurate method for measuring vitamin and mineral levels is through a blood test. It is also important to work with someone knowledgeable in nutritional therapy. While large doses of some vitamins and minerals may not be harmful, others can be toxic. Once supplements are chosen, they should be phased in slowly - over several weeks - and then the effects observed for one to two months.

If you are considering the use of medications, contact a medical professional experienced in treating autism to learn of possible side effects. People with autism may have very sensitive nervous systems and normally recommended dosages may need to be adjusted. Even the use of large doses of vitamins should be done under the supervision of a medical doctor.

Question:
8. Why do vitamins and minerals need to be given in small, incremental amounts?

 

 

Dietary Treatments
Individuals with autism may exhibit low tolerance of or allergies to certain foods or chemicals. While not a specific cause of autism, these food intolerances or allergies may contribute to behavioral problems. Many parents and professionals have reported significant changes when specific substances are eliminated from the child's diet.

Individuals with autism seem to have trouble digesting proteins such as gluten and casein. Gluten is found in wheat, oats and rye; casein in dairy products. The incomplete breakdown and the excessive absorption of protein may cause disruption in biochemical and neuro-regulatory processes in the brain, affecting brain functions. Until there is more information as to why these proteins are not broken down, the removal of the proteins from the diet is the only way to prevent further neurological and gastrointestinal damage.

It is important not to withdraw gluten/casein food products at once from a child's diet, as there can be withdrawal symptoms. Often, soy and rice milk can be substituted for cow's milk. Flours made from these two grains also can be used to bake bread and other items for the child.

Question:
9. Removal of gluten and casein from the diet helps to prevent damage to the ______ and ______.

 

 

Most of the above material was taken from the website Autism Society of America: http://autism-society.org

A Personal History
These are some personal experiences of an autistic person, Temple Grandin. She is a mechanical engineer and associate professor of animal sciences at Colorado State University in the U.S. She has written books about teaching autistic children and has a video series used in teacher education.

"I was 2.5 years old when I began showing signs of autism: not talking, repetitous behavior, and tantrums. Not being able to communicate in words was a great frustration, so I screamed. Loud, high-pitched noises hurt my ears like a dentist's drill hitting a nerve. I would shut out the hurtful stimuli by rocking or staring at sand dribbling through my fingers.

"As a child, I was like an animal with no instincts to guide me. I was always observing, trying to work out the best ways to behave, yet I never fit in with the rest of the group. When other students swooned over the Beatles, I called their reaction an Interesting Sociological Phenomenon. I wanted to participate but did not know how. I had a few friends who were interested in the same things I was, such as skiing and riding horses. But friendship always revolved around what I did rather than who I was.

"Even today, personal relationships are something I don't really understand. From reading books and talking to people at conventions, I have learned that autistic people who adapt most successfully in personal relationships either choose celibacy or marry someone with similar disabilities.

"Early education and speech therapy pulled me out of the autistic world. Like many autistics, I think in pictures. My artistic abilities became evident when I was in second grade. I had a good eye for color and painted watercolors. But words are like a foreign language to me. I translate them into full-color movies, complete with sound that run like a videotape in my head. When I was a child, I believed that everyone thought in pictures. Not until I went to college did I realize that some people are completely verbal and think only in words. On one of my earliest jobs, I thought another engineer was stupid because he would not see the mistakes in his drawings. Now I understand his problem was a lack of visual thinking and not stupidity.

"Autistics have trouble learning things that cannot be thought about in pictures. The easiest words for an autistic child to learn are nouns because they relate directly to pictures. Spatial words such as "over" and "under" had no meaning for me until I had a visual image to fix them in my memory. Teachers who work with autistic children need to understand associative thought patterns. But visual thinking is more than just associations. Concepts can also be formed visually. When I was little, I had to figure out that small dogs were not cats. After looking at large and small dogs, I realized that they all had the same nose. This was a common visual feature of all the dogs but none of the cats.

"At puberty, I was desperate for relief from nervous agitation. At my aunt's ranch, I observed that cows sometimes appeared to relax when they were held in a squeeze chute - a device for holding cows when veteranarians need to do surgery procedures. The device holds the animal tightly on either side so it cannot move. After a horrible case of nervousness, I got in the chute and was held tightly. For about 45 minutes I was much calmer. Then I decided to build a squeeze chute for myself which I could use when I felt nervous. (This is an example of sensory stimulation.)

"I have had a successful career in designing mechanical systems to handle large animals. Major ranches and meat companies all over the world use my equipment designs. When I was in high school, many of my teachers and my psychologist wanted me to stop thinking about cattle and chutes. However, one of my high school teachers suggested that I read psychology journals and study so that I could learn why cattle chutes had a relaxing effect. If my interest had been taken away, I may have had to live in an institution. Do not confuse intense interest with stereotypical behavior, such as rocking or hand flapping. An intense interest in something outside the autistic's mind and should be used to motivate and stimulate his thinking.

"For autistic children in the classroom, I think it should be quiet and free from distracting noises. Autistic children cannot modulate noise - they lose concentration. Some teachers have found that a child can wear headphones with soothing music and this helps them to concentrate better. Visiting a shopping mall or large store can be tolerated with the use of headphones. Calming sensory activities before school lessons or speech therapy may help to improve learning. They helped me.

"Abstract concepts such as getting along with other people need visual images. For example, my visual image for relationships with other people was a glass door. If you push on it too hard, it will break. I realized that the building of a relationship is not an intense process, but it goes slowly so that I can understand the other person."

Most of this lecture was taken from the website called "AUTISM HOME PAGE."

Other materials were taken from "Teaching Tips from a Recovered Autistic" by Temple Grandin, 1988, Focus on Autistic Behavior, 3(1).